Pharmacy Daily | Deprescribing role in memory clinics

PHARMACISTS could play a critical role in identifying unnecessary and inappropriately prescribed medicines among patients of memory clinics, researchers believe.

The paper published in Research in Social and Administrative Pharmacy found evidence to support a pharmacist-led deprescribing intervention for community-dwelling memory clinic patients, to combat the risk of medication-related problems.

The authors noted that deprescribing could reduce inappropriate medication use and potentially improve health outcomes for patients with impaired cognitive function.

The intervention involved accredited pharmacists obtaining a comprehensive medication history of all prescription and over-the-counter medicines used by individual patients, before conducting a medication review to assess the clinical appropriateness of individuals' medication and with ability to manage their medications, assessing whether medications could be ceased or dosage changed, developing plans to initiate medication withdrawal and finally contacting the patient's GP to ensure receipt of the report and to discuss recommendations and offer ongoing assistance as appropriate.

Of the 46 patients who received the intervention, pharmacists made deprescribing recommendations for 43, and 124 medicines.

Vitamins and complementary medicines were the most frequently deprescribed (39.6%), potentially inappropriate medications of patients with a cognitive impairment (18.9%), cardiovascular medications (15.1%), analgesics (15.1%) and proton pump inhibitors (5.6%).

Of the 261 recommendations made by pharmacists, 136 had been partially or completely implemented after six months, with participants who had medications ceased or doses reduced reporting a reduction in regiment complexity and self-reported dizziness, compared with those whose medication had remained the same post-intervention.